One in five home birth mums rushed to hospital

UP TO one in five pregnant women who opts for a home birth has to be rushed to hospital as a result of potentially life-threatening complications.

Disturbing new figures reveal that the dream of a “natural birth” frequently ends with a 999 call as a result of breech births, abnormal baby heart rate, high blood pressure and the need for an emergency caesarean-section.

Experts said expectant mothers who opted for home birth needed to be given more information about the potential risks.

Up to one in five women who give birth at home need emergency medical help.

All of Scotland’s health boards were asked to give details of the number of home births in their area and how many had to be transferred to hospital during Labour.

NHS Lothian revealed that of the 249 who opted for a home birth last year, 46 were rushed into hospital during Labour.

Ayrshire and Arran said of 27 planned home births in 2011, six ended with an ambulance journey to hospital.

Greater Glasgow and Clyde said nine out of 63 home births – one in seven – ended with an emergency call.

Many other health boards refused to reveal their figures, claiming it might lead to identification of the women involved.

As well as serious medical problems arising, some home births were ended at the request of the mother who wanted to be transferred to hospital to receive better pain relief, such as an epidural.

A-list mums including Cindy Crawford have given birth at home.

Gillian Smith, Director of Royal College of Midwives in Scotland, said women should not be put off home births but should be made aware of the risks.

She said: “There are certain risk factors, but they are on an individual basis.

“For mothers it could be high blood pressure, bleeding, or failure for labour to progress.

“For babies the risks could be problems with their heartbeat. It could also be that the baby is not in the right position.”

She added: “It is up to women to look at the information from the freedom of information request, consider it, and then make their own decision.

“There are reasons that women want to give birth at home. You are in your own environment, surrounded by people you choose to be there, and not in a “conveyer belt” situation like some people see giving birth at hospital to be.”

First-time

Dr Amy Tuteur, an obstetrician, who writes the anti-home birthing “Skeptical Ob” blog claims first-time mothers had a 40% chance of being transferred to hospital following a failed home birth.

Dr Tuteur said: “Almost all studies show that homebirth increases neonatal death rates, but the studies that have the safest homebirth outcomes, from the Netherlands, Canada, and the UK, all have high transfer rates, approaching 40% for first time mothers.

“The primary risk of homebirth is death of the baby. There are emergencies that can occur without warning during childbirth such as a prolonged drop in foetal heart rate requiring an immediate C-section or a baby who requires an expert resuscitation with intubation in order to begin breathing. If either of those occurs at home, the baby will die.”

Jusztina (corr) Hermann, 34, a theatre director and performer from Edinburgh, was rushed into hospital during her home birth in 2006.

Jusztina, said: “I had a beautiful pregnancy, with no sickness or pain, and I fully planned to give birth at home. I knew it would be painful but I thought ‘millions of women have done this before’ and I wanted to give birth in a natural way, without using painkillers.”

But 28 hours after her contractions began, and a failure for her labour to progress, midwives suggested to Jusztina that she go into hospital and she was transferred to Edinburgh’s Royal Infirmary.

She said: “I attempted to have a water birth when I got to the hospital but I just became completely exhausted. After 48 hours of labour I was given an epidural, my daughter’s heartbeat had gone crazy and I was falling asleep in between contractions as I had lost two nights sleep.

Relieved

“In the end I was given an emergency caesarean section. I was just so relieved at that point.”

Jusztina, who is due a second baby later this year is un-decided whether she will try for a second home birth. “I found the whole experience incredibly traumatic, each and every point in my birthing plan went the opposite way. I am meeting with a doctor in two weeks time to discuss my birthing options, but I have not made my mind up as yet,” she added.

Leanne O’Donnell, a mother from Fife, who had a successful home birth, said women taken to hospital during labour are usually “really glad” they spent some of the birth at home.

She said: “Home births could still be positive even if they become transfers to hospital. They are seldom a ‘bad experience,’ usually the women seem really glad that they stayed at home as long as possible and that when they eventually get to hospital the interventions are warranted. They nearly always intend to plan a home birth next time.”

Maria Wilson, Chief Midwife at NHS Lothian said: “We support women to give birth where they chose, in our hospitals, birth centre or in their own homes.”

“Women are given an opportunity to fully discuss their birth options and the risks and the benefits of their choices with a midwife before making a decision about where to have their baby.”

“If a women opts to give birth at home, our team of skilled and experienced midwifes ensure the women and her partner understand any potential risks and will care for the women and baby during and after the birth. The midwives will continually monitor the mother and baby during the labour and birth and if complications arise, will make arrangements for a safe and fast transfer to hospital.”

Home birth campaigner Caroline Lovell, from Australia, hit the head lines earlier this year after she died during her own home labour.

The 36-year-old went into cardiac arrest while giving birth to her second daughter, Zahra, at her home.

She was taken to hospital but died the next day. Her daughter survived.

8 COMMENTS

Transfer to hospital is not a failure to birth at home but proof that the women and their midwives are making appropriate choices based on the situation on the day. It actually should be celebrated as a sign that the model of care is working as it should

Amy Tuteur, who is actually not licensed to practice as a physician, is known here in the States as an internet troll who leads an anti-home birth propaganda campaign with the intent of making home birth illegal. She’s managed to tone down her rhetoric for this audience, but make no mistake about it–she wants to follow in the footsteps of state governments in countries like Croatia, Hungary, Bulgaria, Lithuania, Slovenia, and Serbia, where not only are home birth midwives criminalized, but so too are the parents whose babies are born at home.

In the former Soviet bloc it’s all about exercising police-state power. In the US it’s all about profit. Maternity care is a multi-billion dollar industry that’s a virtual cash cow for our for-profit health care system. Amy likes to claim that home birth does not represent a threat to the bottom line, but the fact is that the rates of home birth in the US are steadily increasing, and more women are seeking out alternatives to standard obstetrical care. Studies conducted here, which Amy likes to try to discredit with her smoke-and-mirrors use of statistics, have found a transport rate of closer to 10% of home births, with a small fraction of them being actual emergencies. No doubt a closer look at the numbers in the UK would find the same.

This is an unfair statement. Dr Tuteur is a leading advocate against home birth and has catalogued the rise in perinatal death associated with home birth. As a physician, I have read Dr Tuteur’s interpretations of the data with interest and agree completely. Compared to hospital birth, a home birth is not safe.

Amy Teuters is a maternal health advocate who speaks out for the sake of protecting mothers and babies in the US, where just about anybody can call themselves a midwife and take money for it. Many women are unfortunately duped by these frauds. I’ve corresponded with her and she’s a very warm person. She doesn’t want to deprive women of their rights. She wants them to be informed and empowered to protect themselves and their families. As a woman, I appreciate her advocacy.

This is for Dr. Dad…You write that it’s all about profit…well, sir, I hate to burst your bubble, but the CPM’s in the United States are asking a bundle of money from those women seeking to escape from the medical system, and MANY, if not most, of these midwives are totally unqualified to attend home births. Dr Teuter may or may not have ulterior motives, but, like her, I am also frustrated by the numbers of hurt and dead babies I know about since CPM licensing began. I would say that the internet trolls are the midwives who misrepresent themselves to trusting and vulnerable pregnant ladies for the SAKE OF PROFIT.

So glad I live in the UK where I was able to make an informed decision as to place of birth under the care of educated and supportive obstetricians and midwives. Two fantastic births, the memories of which I will treasure forever, for all the right reasons. Thank you UK doctors and midwives who work together to let women make educated choices.

In reply to Lydi Owen: Dear Lydi, have you considered the number of babies hurt and dead as a result of hospital births in the US for comparison? It is so easy to criticise home births and the midwives who support them. There is no training to be a home birth midwife here in the UK, there is just training to be a midwife. Homebirth is suitable for all women with normal low risk pregnancies, because childbirth is usually normal and natural and midwives are experts in normal and natural. But we do not have a crystal ball that can tell us which woman will develop unexpected complications, what we can do is transfer. And as Andrea said in her post from 27th June it is an appropriate and positive attribution, not negative. for the midwife to detect deviations from normal and transfer the woman to hospital means she is providing excellent and safe care and she should be commended on that. What we all need to realise and remember is that nothing in life is without risk. going to work every morning carries risks, falling in love carries risks, going on holiday carries risks, and falling pregnant carries risks. yet millions of people around the world do these these things every day and some get hurt and some die, but most are OK. women have been giving birth in many different circumstances for millenia. But what we are arguing today is the right of the women to decide the level of risk they are prepared to take and accept in deciding for themselves where and how they want to give birth. It is their Human Right to make these decisions. Yet they cannot make them freely if we attempt to outlaw certain options or imprison those who could enable these options!! In that case we are DEPRIVING women their Human Rights!! is that right?

Over the phone, a doctor tried to get me to go to a hospital. I felt fine and saw no reason to go. What if I were easily manipulated by a doctor? I would’ve become a 1 in 5. My baby was born in water and was just fine.